Provider Demographics
NPI:1265687750
Name:SPRING, ANGIE SEARAN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:SEARAN
Last Name:SPRING
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HUETH LN
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8153
Mailing Address - Country:US
Mailing Address - Phone:406-862-0943
Mailing Address - Fax:
Practice Address - Street 1:125 HUETH LN
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-8153
Practice Address - Country:US
Practice Address - Phone:406-862-0943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist